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Lymphangioleiomyomatosis and Langerhans cell histiocytosis - two case reports from our practice. SRP ARK CELOK LEK 2022. [DOI: 10.2298/sarh211203034m] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Introduction. Lymphangioleiomyomatosis (LAM) and pulmonary Langerhans cell
histiocytosis (PLCH) are the most common pulmonary cystic diseases. Although
they differ in pathogenesis, they share several features. The aim of this
paper is to present the similarities and differences between these diseases,
as well as to describe two cases from our practice. Outlines of cases. The
patient with LAM (43 y.) has pulmonary changes detected during regular
examination within the underlying disease - tuberous sclerosis. Four years
after starting therapy with everolimus she is still respiratory
asymptomatic, a slight radiological deterioration of cystic changes is
registered, the diffusion capacity is declining (for 12%). The second
patient (23 y.) was admitted due to bilateral radiological lung changes and
symptoms in the form of dry cough, quick fatigue and chest pain.
Pathohistological examination of the transbronchial biopsy showed numerous
large-core histiocytes, immunohistochemically positive for CD1a and S100, so
it has been concluded that it is Langerhans cell histiocytosis. Cessation of
smoking was advised. The follow-up examinations show withdrawal of symptoms
and an orderly finding of lung function, chest HRCT indicates slight
regression of changes. In the meantime, the patient gave birth to a healthy
child, the pregnancy and prenatal period went smoothly. Conclusion. These
diseases are extremely rare and in cooperation with other specialties should
be distinguished from diseases that mimic lung cysts.
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